Specific Areas of Treatment for CRPS

The Good, Bad, and the Ugly: Treatment of Complex Regional Pain Syndrome (CRPS) in Pediatrics

Centralized Pain Reflex neurovascular dystrophy (RND) Reflex Sympathetic Dystrophy Syndrome (RSD)

Central and Peripheral Nervous System High Level of Nerve Impulses and Pain Signals

Immune and Autonomic Responses

By Heidi Kempert, PTA kemperh@

Cleveland Clinic Children's Hospital for Rehabilitation Pediatric Pain Rehab Program

Specific Areas of Treatment for CRPS

? Desensitization ? Swelling management ? Range of motion ? Weight bearing ? Gait training ? Functional mobility ? Strength and endurance ? Symmetry and body awareness ? Balance and neuromuscular re-education ? Guarding/Habitual movement education ? Patient and family education ? Patient goals and motivations! ? Be creative and fun!

A Spectrum... Tolerance, Reactions, Progression

Quick diagnosis and initiation of therapies is important after ruling out acute injury and obtaining appropriate medical clearance

Using A Multidisciplinary Approach: Finding a Balance

Less Support/Fear

of Falling

Stress

Alignment

Participation

Weight Bearing

Expectations

Breathing Feeling Unstable Anxiety

Introduce Coping Strategies

? Imagery ? Acupressure ? Deep Breathing/Belly

Breathing

? Distraction ? Progressive Muscle Relaxation ? Positive Mental Attitude ? Problem Solving

Pain

10/9/2017 1

Return to Life

Return to School - Modified Mobility - Movement/Pace breaks - Modified Gym Class or Recess

* Talk with Schools!

Return to Sports/Leisure - Gradual progression

- Prevents acute injury or flare - Only change one "area" of challenge

- Practice - Sports - Intensity - Total Time

*Talk with Coaches!

Case Studies

Walking/Night Splint

Supported Positioning

Discharge Day

Pre-gait

Aquatics Discharge Day

Kneeling Push-Ups Elbow Planks Step-Ups Jump Rope Squat Box Lifts Box Carry Sit to Stand 6 minute walk

Range

LEFS

0 ? 80

UEFI

0 ? 80

Pain

0 ? 10

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